The Brief: Sept. 17, 2013

The Big Conversation

Gov. Rick Perry has added more fuel to his fight with the federal government over Obamacare.

As the Tribune's Becca Aaronson reports, Perry on Monday directed Texas' Health and Human Services Commission to seek a federal waiver to reform Medicaid as the state sees fit. Perry maintained, however, that the state would not expand the program under federal health care reform.

"Seemingly, the president and his administration are content to simply throw money at a problem and hope that any problems will resolve themselves," Perry wrote in a letter to the head of the agency. "My response, and the response of the Texas Legislature, has been crystal clear: Texas will not expand Medicaid under Obamacare."

Perry called on the agency to request a block grant, or lump sum, that would give the state more flexibility in operating Medicaid. For Texas, that includes the ability to make changes to the program without seeking federal approval and to continue asset testing. The waiver, he wrote, would let Texas "transform our program into one that encourages personal responsibility, reduces dependence on the government, reins in program cost growth and efficiently improves coordination of care."

Texas' push for more flexibility with Medicaid isn't new. But Perry's call for a block grant comes as the number of Republican governors who have reversed course on Medicaid expansion continues to climb. On Monday, Tom Corbett of Pennsylvania became the 10th GOP governor to agree to the expansion — though whether the Obama administration will agree to Corbett's terms remains unclear.

It also remains unclear how the administration will respond to Texas' request. Though such waivers were recently considered long shots, Health and Human Services Secretary Kathleen Sebelius said last month during a visit to the state that the federal government is open to a "uniquely Texan" approach to expanding Medicaid. 

"But as far as I know," she added, "those conversations, at least with the state officials, are not taking place right now."

Culled

•    Dewhurst forced to play defense in Houston debate (Houston Chronicle): "During his first public encounter with three Republican challengers, Lt. Gov. David Dewhurst Monday spent an uncomfortable hour in Houston defending his 10-year record against assertions he allowed Democrats and 'mob rule' to thwart the passage of conservative legislation. In a debate sponsored by Houston's Ronald Reagan Republican Women's Club, Sen. Dan Patrick, R-Houston, said missteps by Dewhurst permitted Fort Worth Democrat Wendy Davis to nearly derail abortion regulations with a filibuster in June that could have been prevented. 'Wendy Davis should never have had the floor that day,' Patrick said. 'There are many ways we could have stopped that from happening.' … Added another challenger, Agriculture Commissioner Todd Staples: 'You don't go out to eat and drink with lobbyists when there are issues on the floor of the Senate that you are supposed to be dealing with. There are five months to deal with those issues. ... It's about getting there early and staying there late.'"

•    Navy Yard shooter had at least two gun-related incidents in past (Fort Worth Star-Telegram): "Friends say Aaron Alexis regularly meditated at a local Buddhist temple, was unfailingly courteous and never showed signs of the violence that is now his legacy. But police reports paint a darker picture of the Fort Worth man, including an anger-fueled 'blackout' and shooting in Seattle in 2004 and, more recently, a firearms incident at a Fort Worth apartment, after which a neighbor told police that she was 'terrified' of him."

•    Border Democrats See Immigration Reform Window Closing (The Texas Tribune): "Congressional border Democrats still seeking a deal on immigration reform that includes a pathway to citizenship conceded on Monday that time is slipping away and the issue could be on hold until next year — or beyond."

•    Committee Plans Hearings in UT Regent Impeachment Probe (TT): "The Select Committee on Transparency in State Agency Operations on Monday began outlining its plans to investigate whether a University of Texas regent should face impeachment."

Quote to Note: "If it’s Wendy Davis vs. Greg Abbott, then she has a 40 percent chance of winning." — GOP gubernatorial candidate Tom Pauken at a NE Tarrant Tea Party meeting this week

Must-Read

• Q&A with Julian Castro: Texas politics, the GOP and Hispanics, and a Biden-Clinton battle in 2016, The Washington Post
  
• Complex Science at Issue in Politics of Fetal Pain, The New York Times
• Mackowiak: Davis leading contender for sacrificial lamb, Austin American-Statesman
• Stanford: Even if Davis loses, she wins, Austin American-Statesman
• State rep calls on VIA to cancel streetcar plan, San Antonio Express-News
• As Illegal Crossings Rise in Texas, a Cat-and-Mouse Game With Border Patrol Intensifies, The World